Survey Text

2016
2008
top
2016
Survey form view entire document:  text  image
Question ID: BAL.060_05.000

Instrument Variable Name: BTYPE_5
Questionnaire File Name: Sample Adult
Question Text:
* Read if necessary. This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each.
...Blurring of your vision when you move your head
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: Sample adults 18+ had a dizziness or balance problem in the last 12 months or at least one balance related problem in the past 12 months
Skip Instructions:
(1,2,R,D) [goto BTYPE_6]

Survey form view entire document:  text  image
Question ID: CBL.037_00.000

Instrument Variable Name: CBALBLR
Questionnaire File Name: Sample Child
Question Text:
*Read if necessary.
DURING THE PAST 12 MONTHS, has [fill1: S.C. name] been bothered by episodes of any of the following dizziness or balance problems...
blurred vision when head is moving, or rapid eye movements known as ?bouncing? eyes causing disorientation?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: Sample children 3+
Skip Instructions:
(1,2,R,D) [goto CBALOTH]

top
2008
Survey form view entire document:  text  image
Question ID:BAL.060_05.000

Instrument Variable Name:BTYPE_05
QuestionText:
* Read if necessary. This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each....Blurring of your vision when you move your head
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had a problem(s) with dizziness or balance
SkipInstructions:
(1,2,R,D) [goto BTYPE_06]